careers: jobs focus

Lifelong point of contact

Nephrology nursing has seen a number of new and exciting role developments as medical techniques improve

ARING FOR patients with renal failure attracts nurses who wish to develop their skills and extend their roles. Although multidisciplinary teamwork is fundamental in caring for patients with renal failure, nephrology nurses are a focal point of contact for patients and their families. There are numerous causes of renal failure of which diabetes and hypertension are the most common. Because these conditions are increasing in the UK, the number of people with endstage renal disease is rising each year. Patients starting on renal replacement therapy require continuing and supportive care throughout their lives. But haemodialysis and peritoneal dialysis techniques have much improved over the years giving patients a better quality of life. New roles Over the past few years, a number of new nephrology nursing roles have developed anaemia co-ordinators, pre-dialysis nurses, vascular access nurses, transplant nurse practitioners and outreach nurses. The creation of more consultant nephrology nurse posts will be inevitable as the demand for further nursing development increases. There is concern, however, that role development between trusts varies considerably. To address this, work is under way to establish a competency framework to outline and define different levels of practice. A specialty skill mix

review to provide recommendations on staffing ratios in relation to patient dependency is also under way. In many units. rotational posts are offered so that nurses are able to sample the various areas that make up a renal unit, such as haemodialysis, peritoneal dialysis, nephrology, transplantation, community care and occasionally paediatrics. These rotational posts often prove attractive to nurses new to the renal environment. After sampling different areas of care they may choose to specialise in a particular area.

and to patients who have received a transplant. Appropriate community care can keep them out of hospital and help them achieve a better quality of life. The recent announcement of a National Service Framework for Renal Services heralds an exciting time for the specialty. The framework will facilitate the integration of agreed national standards into practice thus improving care for all renal patients. Change has always been fast in the renal field and this decade is set to continue the trend. Home haemodialysis, once the mainstay of haemodialysis programmes, is being considered once again. More efficient ways of providing and monitoring haemodialysis are surfacing and innovations in peritoneal dialysis mean that this therapy is constantly improving. Donor rates A very important next step is to improve the organ donor rates, thus increasing the number of transplants. At this years RCN Nephrology Nursing Policy and Practice Groups annual conference, it was emphasised that the government and UK Transplant are campaigning to improve the organ donation rates. Nephrology nursing is a stimulating area of specialist nursing. A nurses commitment to care for chronically ill people and their families brings much reward. Being able to provide support, education, information and innovative care is the basis of good nephrology nursing

Change has always been fast in the renal field and this decade is set to continue the trend
Specialist education in nephrology nursing can be accessed through universities. At present, this is usually offered at diploma level (ENB 136) but will be at degree level in the future. Advanced practitioner courses for the more experienced nephrology nurses are available and there are community nursing modules for outreach nurses. Community care and health promotion are vital to renal patients especially those who undergo peritoneal dialysis in the community

Corrine Jeffrey is Senior Nurse, Renal Unit, Bradford Hospitals NHS Trust and Chair of the RCN Nephrology Policy and Practice Group

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